Juvenice Professional Center Corp

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

ME61828 Issued in FL

Legal business name

JUVENICE PROFESSIONAL CENTER CORP

Practice address

8567 Coral Way
Suite 112
Miami, FL 33155-2335

Phone

(305) 910-9170

Fax

(305) 513-5189

NPI assigned

Apr 15, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Luis Chediak

Title

President

Phone

(305) 910-9170

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243209600000",
    "number": "1780827055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8567 CORAL WAY",
            "address_2": "SUITE 112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552335",
            "telephone_number": "305-910-9170",
            "fax_number": "305-513-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8567 CORAL WAY",
            "address_2": "SUITE 112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552335",
            "telephone_number": "305-910-9170",
            "fax_number": "305-513-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUVENICE PROFESSIONAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-05-25",
        "status": "A",
        "authorized_official_last_name": "CHEDIAK",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-910-9170"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "PT19963",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "ME61828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Maria Justo
• Justwell Fox Holdings LLC
• Justwell Fox Holdings LLC
• Justwell Fox Holdings LLC
• Juvenal E. Martinez, MD, PA
• Juventis LLC
• Juventud Corporation
• Daniela Juvier Abraham
• Tamara Juvier Riesgo, MD
• Martha Alina Juvier

• Preferred Provider Organization in Miami, FL
• Providers in Miami, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.